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Alberta premier threatens sanctions against Calgary clinic set to charge fees

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The Marda Loop Medical Clinic is seen in Calgary, Wednesday, July 26, 2023. Danielle Smith says if a Calgary medical clinic begins charging a fee for faster access to a family doctor, it will be shut down, fined or have medicare payments from the province withheld. THE CANADIAN PRESS/Todd Korol

EDMONTON — Alberta Premier Danielle Smith says if a Calgary medical clinic begins charging a fee for faster access to a family doctor, it will be shut down, fined or have medicare payments from the province withheld. 

Smith says her government is committed to the principles of the Canada Health Act that include patients not paying to access publicly funded services such as doctor visits.

"We won't let it happen," Smith told reporters in Calgary on Friday.

"I signed a protocol with the federal government for 10 years committing to the principles of the Canada Health Act. That means that you cannot charge to access insured services.

"If that's what they are doing, they will be shut down, they will be fined, or we will withhold payments to them."

The Marda Loop Medical Clinic has told patients it will begin offering membership-fee based services, including faster access to its physician, starting Tuesday.

The annual membership is set at $2,200 for an individual and $4,800 for a family.

The clinic promises to keep one day a week open for patients who have not signed on to the membership plan.

Health Canada has said the fees violate the provisions of the act, which guarantee a level playing field for access to insured medical services paid for from the public purse.

The clinic did not respond Friday to a request for comment.

The new program was communicated to Marda Loop patients in a recent email. It is not mentioned on the clinic's website and the provincial regulator, the College of Physicians and Surgeons of Alberta, said earlier this week it was not asked to review the clinic's new fee model before implementation.

In the email to patients, clinic owner and physician Sally Talbot-Jones characterized the move as "a transformative health-care initiative" to provide better service while reducing stress, lost time and productivity due to extended waits to see a physician.

"You and your family should not have to sacrifice your time or finances due to inadequate access to health care," wrote Talbot-Jones.

In an interview with CBC News earlier this week, she cited financial struggles with office overhead as a reason for the change.

Talbot-Jones has declined repeated requests for an interview from The Canadian Press.

Health Canada has advised Alberta there are multiple options to fix the Marda Loop situation, such as through policy or legislation, but said a failure to do so risks a reduction in federal health transfer payments to the province.

The Opposition NDP has called for a full investigation by the province, saying the problem expands beyond the Marda Loop clinic.

In a statement Friday, Health Canada said almost $14 million was deducted from health transfer payments to Alberta in March due to clinics charging fees in return for access to publicly funded MRI and CT scans.

"The (Canada Health) Act is clear: where there is evidence of patient charges, a mandatory deduction to federal health transfer payments to the province or territory must be taken," spokesperson Anne Genier said in an email.

Alberta Health spokesman Scott Johnston said they dispute the federal withholding of funds.

“Alberta has in place a robust audit system to ensure there are no extra billing or user charge issues. This is why we don’t agree with the findings of the federal government," said Johnston.

"The Government of Alberta will work with the federal government on addressing this issue and ensuring Alberta receives the full Canada Health Transfer payment that it is entitled to.”

In a statement on its website Friday, the College of Physicians and Surgeons of Alberta said it goes against its standard of practice for any physician to charge patients directly for insured services.

The College said it will act on complaints, but added, "under legislation, (the College) is unable to share information about specific complaints in our complaints process, including whether or not a complaint has been filed."

It added: "The vast majority of physicians practicing in Alberta are professional and (the College) thanks them for their continued adherence to their professional responsibilities."

Smith made a promise in the recent election that Albertans will not pay to see a family doctor. 

The NDP, along with the advocacy organization Friends of Medicare, said the Marda Loop plan threatens a disastrous domino effect for patients who cannot pay but still need primary care, and referrals for tests and more complex procedures.

This report by The Canadian Press was first published July 28, 2023.

Dean Bennett, The Canadian Press

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